Foundation Final: Exam 1

Ethical principles for professional nursing practice in a clinical setting are guided by the principles of conduct that are written as the: a. Nurse Practice Act (NPA) written by state legislation b. Code of Ethics for Nurses c. Standards of care from experts in the practice field d. Good Samaritan laws for civil guidelines

b. Code of Ethics for Nurses d. Good Samaritan laws for civil guidelines

What is an example of the doctrine of double effect? a. A medical error doubles the cost the patient's hospital stay b. Nurse gives ordered high dose of morphine to dying patient c. Physician orders the less expensive of two tests d. Health care provider advises patient of two different treatments

b. Nurse gives ordered high dose of morphine to dying patient

The patient is in severe pain and asks for pain medicine. The family refuses all pain medicine because they are afraid the medicine might end the patient's life. Where could the nurse obtain guidance in this situation? a. Discuss the situation with a colleague at another hospital. b. The nurse should not stand in the way of the family wishes. c. Review the literature about providing pain relief with the family. d. Refer the situation to the nursing supervisor

c. Review the literature about providing pain relief with the family.

The spouse of a client who has recently been diagnosed with early-stage Alzheimer's disease asks the nurse to recommend websites that may supplement the spouse's learning about this diagnosis. How should the nurse respond to the spouse's request? a. This is unfortunately not something we currently do for clients in the hospital b. Direct the spouse to online database such as the Cumulative Index to Nursing and Allied Health Literature c. Encourage the spouse the avoid online resources due to the unregulated nature of the internet d. Identify and recommend some credible websites appropriate to the spouse's learning needs

d. Identify and recommend some credible websites appropriate to the spouse's learning needs

A nurse is providing patient care in a hospital setting. Who has responsibility and accountability for the nurse's actions? a. The physician b. The hospital c. The head nurse (or charge nurse) d. The nurse

d. The nurse

A nurse provides client care within a philosophy of ethical decision-making and professional expectations. What is the nurse using as a framework for practice? a. Definition of nursing b. Code of Ethics for Nursing c. Values clarification d. Standard of care

b. Code of Ethics for Nursing

When talking with family over dinner, the nurse shares about a client with infertility at the hospital, identifying the person by name. Which tort has the nurse committed? a. Fraud b. Assault c. Slander d. Invasion of privacy

d. Invasion of privacy

A nurse has taken a telephone order from a physician for an emergency medication. The dose of the medication is abnormally high. What should the nurse do next? a. Question the order for the medication. b. Administer the medication based on the order. c. Refuse to administer the medication d. Document concerns about the order

a. Question the order for the medication.

A nurse forgot to document that a client drank 120ml of water at 0830. It is now 1030. What action should the nurse take? a. Fill out an incident report. b. Document the water for the 0830 time c. Document the water for the 1030 time d. Do not document this water since too much time has lapsed

b. Document the water for the 0830 time

To provide effective nursing care, the nurse should engage in what type of communication with the client and significant others? a. Intrapersonal communication b. Metacommunication c. Therapeutic communication d. Purposive communication

c. Therapeutic communication

When signing a form as a witness, your signature shows that the client: a. Has signed that form and the witness saw it being done b. Was awake and fully alert and not medicated with narcotics. c. Was free to sign without pressure d. Is fully informed and is aware of all consequences

a. Has signed that form and the witness saw it being done

A client refuses to have pain medication administered by injection. The nurse states, "If you don't let me give you the shot, I will get help to hold you down and give it." What tort may the nurse be committing? a. Negligence b. Defamation c. Battery d. Assault

d. Assault

A client is questioning the need for surgery. The client asks the nurse, "What should I do?" Which answer by the nurse is based on advocacy? a. "Tell me why you do not want the surgery." b. "Let me talk to your doctor, and I will let you know what I find out." c. "If I were you, I would not have this surgical procedure." d. "You should ask some of the more experienced nurses this question."

a. "Tell me why you do not want the surgery."

The health care provider is yelling at the nurse in the patient's room because the patient has not received an intravenous antibiotic. Which statement by the nurse demonstrates appropriate assertiveness? a. "Let's go to the nurses' station, and I will explain." b. "You should have written your order more clearly than you did." c. "I have other patients and have been very busy today." d. "It's the fault of the previous nurse, who left it for me to do."

a. "Let's go to the nurses' station, and I will explain."

When caring for a client at the health care facility, the nurse observes that the client is having difficulty understanding the health education. Which action is most appropriate? a. Delegate the health education to a colleague b. Replace one-on-one teaching with written materials c. Assess for cultural differences d. Boost the morale of the client

c. Assess for cultural differences

What is the primary ethical dilemma posed when using restraints on an older adult client in a long-term care setting who is confused? a. It prevents self-directed care. b. It limits personal safety. c. It threatens autonomy. d. It increases confusion.

c. It threatens autonomy.

Even though the nurse may obtain the clients signature on a form, obtaining informed consent is the responsibility of the: a. client b. student nurse c. physician d. nurse

c. physician

To practice ethically, the nurse should avoid: a. Asking the client's family about their views on caring. b. Reviewing past cases before making decisions about practice. c. Allowing an ethics committee to guide the nurse's practice d. Allowing the nurse's own judgment to guide practice.

d. Allowing the nurse's own judgment to guide practice.

A diabetic client discovers that the client's name is published in a research report on diabetic care prepared by the client's nurse. The client is hurt and files a lawsuit against the nurse. Which offense has the nurse committed? a. Invasion of privacy b. Unintentional tort c. Negligence of duty d. Defamation of character

a. Invasion of privacy

The scope of Nursing practice is legally defined by: a. Professional nursing organizations b. Hospital policy and procedure manuals c. Physicians in the employing institutions d. State nurses practice acts

d. State nurses practice acts

You notice another nurse on the floor not wearing gloves when helping a client use the restroom. How do you react? a. This is acceptable behavior if you can guarantee you won't get any bodily fluids on you. b. She is your best friend on the floor so you don't say anything right now. c. Immediately tell the nursing supervisor. d. You should let the nurse know they must use gloves and wash their hands before and after patient care.

d. You should let the nurse know they must use gloves and wash their hands before and after patient care.

The nurse suspects that another staff member may have a substance use disorder. What changes would the nurse observe that would indicate possible substance use? Select all that apply. a. A decrease in personal hygiene and appearance b. Clients frequently reporting ineffective pain relief following administration of opioids c. Adherence to completing work assignment d. Arriving on time to work consistently e. Confusion about clients' plans of care

a. A decrease in personal hygiene and appearance b. Clients frequently reporting ineffective pain relief following administration of opioids e. Confusion about clients' plans of care

The nurse charted the administration of preparation for a colonoscopy in the AM in the progress notes of the client's paper chart, pictured above. Which correct documentation guidelines did the nurse follow? Select all that apply. a. Acknowledge the client's response to the medication b. Leave blanks in the charting c. Sign every entry d. Identify the day and time for each entry e. Document in chronological order

a. Acknowledge the client's response to the medication c. Sign every entry d. Identify the day and time for each entry e. Document in chronological order

Which ethical principle is related to the idea of nursing students controlling their life and outcome of nursing school? a. Autonomy b. Confidentiality c. Nonmaleficence d. Beneficence

a. Autonomy

Which one of the following is the nurse's best legal safeguard? a. Competence, safe practice b. Malpractice insurance c. Patient education d. Union contract

a. Competence, safe practice

The nurse has inadvertently administered medication ordered for Client A to Client B. What is the appropriate nursing action? Select all that apply. a. Contact the provider to report the error. b. Tell Client A that the wrong drugs were given to Client B. c. Complete an incident report. d. Assess Client B thoroughly. e. Do nothing as long as Client B has no reaction.

a. Contact the provider to report the error. c. Complete an incident report. d. Assess Client B thoroughly.

A confused client who fell out of bed because side rails were not used is an example of which type of liability? a. Negligence b. Battery c. Felony d. Assault

a. Negligence

A nurse knows that the expression "Do not cause harm" refers to which ethical principle? a. Nonmaleficence b. Justice c. Fidelity d. Beneficence

a. Nonmaleficence

The client recently immigrated from Mumbai, India. The client was just admitted to the nurse's unit postoperatively following gallstone removal. The client does not speak the dominant language. When using the hospital's interpretive services, which is most important? a. Speak directly to the client. b. Ensure that family members are present c. Give all of the discharge instructions at once d. Have the interpreter write out all of the information listed in the unit brochure.

a. Speak directly to the client.

A nurse is caring for a client who is newly diagnosed with terminal cancer. The nurse enters the client's room and finds the client sitting in the dark crying. Which statement conveys empathy by the nurse? a. "Can you please tell why you are crying?" b. "I know this is hard for you. Is there any way I can help?" c. "Sitting in the dark is not going to cure your cancer. Let's open the curtains." d. "I am sorry you are going through this."

b. "I know this is hard for you. Is there any way I can help?"

The client being admitted to the oncology unit conveys wishes regarding resuscitation in the event of cardiopulmonary arrest. The nurse advises the client that it would be in the client's best interest to obtain which document? a. An order for DNR b. A living will c. Proof of health care power of attorney

b. A living will

A client is brought to the emergency department by an adult child, who states, "I am unable to care for my parent anymore. Although I would like to, financially and physically I can't do it anymore." What ethical problem is the adult child experiencing? a. Dissatisfaction b. Distress c. Dilemma d. uncertainty

b. Distress

A client states that the client's recent fall was caused by his scheduled antihypertensive medications being mistakenly administered by two different nurses, an event that is disputed by both of the nurses identified by the client. Which measure should the nurses prioritize when anticipating that legal action may follow? a. Consult with the hospital's legal department as soon as possible b. Document the client's claim and the events surrounding the alleged incident c. Consult with practice advisors from the state board of nursing d. Enlist support from nursing and non-nursing colleagues from the unit

b. Document the client's claim and the events surrounding the alleged incident

The nurse gives a change-of-shift report to the oncoming nurse. What vital information should the nurse include in the report? Select all that apply. a. The client's hobby is modeling, which we had a conversation about. b. No new labs have been ordered after surgery. c. Ms. J-Lo is in Room 7, admitted postoperatively for an open appendectomy. d. Pain level is currently a 2 following administration of intravenous morphine. e. The client has a clean and dry abdominal dressing. f. The client has two cats at home; the client's mother is taking care of the cats

b. No new labs have been ordered after surgery. c. Ms. J-Lo is in Room 7, admitted postoperatively for an open appendectomy. d. Pain level is currently a 2 following administration of intravenous morphine. e. The client has a clean and dry abdominal dressing.

You are a nurse in an ER. Your elderly client appears withdrawn around his daughter and has questionable bruises. What action should the nurse take? a. Tell the client's daughter "how dare you abuse your father" b. Notify the nursing supervisor for further guidance. c. Ask the daughter to leave d. Ask for advice from another nurse on the floor

b. Notify the nursing supervisor for further guidance.

A client is brought to the emergency department in an unconscious state with a head injury. The client requires surgery to remove a blood clot. What would be the appropriate nursing intervention in keeping with the policy of informed consent prior to a surgical procedure? a. The nurse ensures that the client signs the consent form b. The nurse ensures that the client's family signs the consent form c. The nurse informs the family about the living will d. The nurse informs the family about advance directives

b. The nurse ensures that the client's family signs the consent form

Which actions should the nurse take to ensure that client information remains confidential? Select all that apply. a. Print client information to a printer shared with another unit b. Verify the number in the fax machine as correct prior to transmission c. Exit the client's room when called on the hospital-issued cell phone about another client on the team d. Access client information on the portable computer in the hallway where visitors are present e. Dispose of client SBAR forms in a secure container for shredding of documents at the end of shift

b. Verify the number in the fax machine as correct prior to transmission c. Exit the client's room when called on the hospital-issued cell phone about another client on the team. e. Dispose of client SBAR forms in a secure container for shredding of documents at the end of shift

A nurse posts the following to their social media account; "Today was a bad day at work; my patients were tough to work with, especially one in particular". What response by the nurse manager is most appropriate? a. "Its okay to discuss these things with your best friend, but not on social media" b. "The information being posted on social media is inappropriate. Make sure to discuss information about client's privately with family" c. "Any information that can identify a person is considered a breach of client privacy" d. "You may continue to post about a client as long as you do not use the client's name"

c. "Any information that can identify a person is considered a breach of client privacy"

The nurse calls the health care provider due to changes in the client's status. Using the SBAR, the nurse is about to address Recommendation. Which statement appropriately supports this part of the SBAR? a. "The client was admitted today with a urinary tract infection." b. "The client's temperature has been 102°F (38.9°C) for the last 6 hours." c. "Will you prescribe a complete blood count to check the white blood cell count and a culture?" d. "Will you prescribe a complete blood count to check the white blood cell count and a culture?"

c. "Will you prescribe a complete blood count to check the white blood cell count and a culture?"

You have four clients with discharge orders. Which client below would you want to suggest homecare for? a. A 46 year old who uses illegal drugs. b. A 59 year old client who is a left lower leg amputee who had an appendectomy and has been ambulating okay. c. A 40 year old diabetic who needs assistance getting to the restroom. d. An 80 year old who has used a walker for years

c. A 40 year old diabetic who needs assistance getting to the restroom.

The nurse is completing documentation after an education session with a client. Which statement best demonstrates detailed documentation of an effective teaching plan? a. Spouse taught to flush feeding tube before and after medication. Denied further instruction needed b. Lecture provided about infection, and client stated understanding what infection is c. Demonstrated cord care to mother, who stated understanding and performed return demonstration using correct technique d. Discussed wet-to-dry dressing changes, and client stated understanding

c. Demonstrated cord care to mother, who stated understanding and performed return demonstration using correct technique

Which actions should the nurse perform to limit casual access to the identity of clients? Select all that apply. a. Posting information linking a client with diagnosis, treatment, and procedure on whiteboards at nurses station b. Making the names of clients on charts visible to the public. c. Keeping record of people who have access to clients' records d. Obscuring identifiable names of clients and private information about clients on clipboards e. Placing fax machines, filing cabinets, and medical records in areas that are off-limits to the public

c. Keeping record of people who have access to clients' records d. Obscuring identifiable names of clients and private information about clients on clipboards e. Placing fax machines, filing cabinets, and medical records in areas that are off-limits to the public

Most litigation in the hospital comes from the: a. Nurse documenting blame on the physician when a mistake is made b. Supervisor watching a new employee check his or her skills level c. Nurse following an order that is incomplete or incorrect d. Nurse abandoning the clients when going to lunch

c. Nurse following an order that is incomplete or incorrect

Which situation is an example of battery that the nurse may witness while performing duties at the health care facility? a. Verbal violence toward another nurse b. Telling the client that client may not leave the hospital c. Performing a surgical procedure without getting consent d. Taking the client's photograph without consent

c. Performing a surgical procedure without getting consent

The nurse is educating a client regarding use of the incentive spirometer. When evaluating the client's knowledge about the incentive spirometer, which best represents that the client has learned correct use of this device? a. The client states understanding and passes a written test b. The client nods when asked about process and assists with cleanup c. The client organizes materials needed and gives return demonstration d. The client verbalizes items needed and how to perform the skill

c. The client organizes materials needed and gives return demonstration

A client nearing the end of life requests that the client be given no food or fluids. The physician orders the insertion of a feeding tube to feed the client. What is the primary concern of the nurse providing care? a. The physician's order creates a barrier to establishing an effective nurse-client relationship. b. The nurse must follow the physician's orders. c. The nurse faces an ethical dilemma about inconsistent courses of action. d. The nurse is unable to provide care for the client.

c. The nurse faces an ethical dilemma about inconsistent courses of action.

A nurse is transfusing multiple units of packed red blood cells. After the second unit is transfused, the nurse auscultates bilateral crackles at the bases of the client's lungs and the client reports dyspnea (shortness of breath). The nurse telephones the health care provider and provides an SBAR report. Which statement represents the second step in this type of communication? a. "It seems like the client had fluid volume overload" b. "I am calling because the client receiving blood had developed dyspnea and had crackles" c. "I think the client would benefit from intravenous furosemide" d. "This client had a medical history of heart failure"

d. "This client had a medical history of heart failure"

An illegal immigrant with no health insurance sustained life-threatening injuries in an automobile accident. Which action in this case demonstrates the ethical principle of justice? a. Telling the client honest information about the client's medical condition and prognosis b. Avoiding treating the client so as to not do any additional harm c. Filing the paperwork for the client to receive retroactive health insurance d. Airlifting the client to a local trauma center for emergency surgery

d. Airlifting the client to a local trauma center for emergency surgery

A nurse volunteers to serve on the hospital ethics committee. Which action should the nurse expect to take as a member of the ethics committee? a. Decide the care for a client who is unable to voice an opinion. b. Convince the family to choose a specific course of action. c. Present options about the type of care. d. Assist in decision making based on the client's best interests.

d. Assist in decision making based on the client's best interests.

The nursing is caring for a client who requests to see a copy of the client's own health care records. What action by the nurse is most appropriate? a. Explain the only a paper copy of the healthcare record can be viewed by the client. b. Discuss how the hospital can be fined for allowing clients to view their health care records. c. Access the health care record at the bedside and show the client how to navigate the electronic health record. d. Review the hospital's process for allowing clients to view their health care records.

d. Review the hospital's process for allowing clients to view their health care records